Advocates of abstinence-only say equipping teens for safe sex, without their parents’ involvement, signals a surrender to reality rather than a victory.

But health officials say that curbing the teen birth rate relies on a simple formula — and it has little to do with curbing teen sexual appetites.

“It’s a foolproof method,” said Susan Levy, executive director of the Boulder Valley Women’s Health Center. “You have to educate them first, and then you have to give them access to birth control. Then take away the possibility that the woman can use it incorrectly or inconsistently.”

Clinics have to remove the barriers of cost and parental notification, she said.

It mirrors a national trend: In 1991, the U.S. teen birth rate was 62 births for every 1,000 girls, falling to 27 births per 1,000 in 2013 — a decline of about 56 percent. That’s still one of the highest rates in the developed world.

Three-quarters of the decline in Colorado was among girls and women served by the initiative in clinics, Levy and state officials said.

“I’d love to think there is no longer a debate over this,” said Lisa Olcese, executive director of Colorado Youth Matter, a nonprofit promoting “the healthy sexual development of all young people.”

“The math is simple,” she said. “What we’re doing is working, and we need to keep doing it.”

Nathaly Chavez, 18, is a returning patient of the family planning clinic at Children’s Hospital Colorado. Beginning a new job, Chavez recently lost Medicaid coverage but hasn’t yet gained private insurance.

She said she can rely on the program for something she otherwise couldn’t afford.

“It’s really a big deal to know that,” Chavez said. “Ever since I started coming here, I feel I’ve been really helped with all my needs.”

Word of mouth among teens is the clinic’s most important marketing tool, said clinic director Dr. Liz Romer.

“They know they won’t be judged here. They’ll be respected,” she said. “We now know a lot more about teens and how their brains work.”

At Focus on the Family, a Colorado Springs-based Christian family-counseling ministry with an international following, the idea of a state program handing out contraception to teens without their parents’ knowledge is considered reprehensible.

Parents should be teens’ sex educators and the keepers of their health, welfare and morality, said Carrie Gordon Earll, the ministry’s director of public policy.

“For government to distribute contraceptives to teenagers without parental consent bypasses this critical parental right and responsibility,” Earll said. “Colorado law prohibits a teenager from getting a tattoo without parental consent. For the last several years, the legislature has considered bills to ban teen use of tanning beds, yet as I understand it, teens can be inserted with an IUD (intrauterine device) without parental knowledge.

“Something is wrong with this picture.”

Polling has shown that a majority of Americans favor giving birth control to school-aged teenagers, but support for doing so without parental consent appears less solid.

A 2007 Associated Press-Ipsos poll found 67 percent favored giving students access to birth control in schools, but 55 percent of those said they would limit it to teens whose parents consented. Those views may be evolving.

Supreme Court rulings have extended the constitutional right to privacy to a minor’s decision to use contraceptives, and states have expanded minors’ authority in this area.

The Guttmacher Institute, a center focused on reproductive health and rights, has identified 21 states, including Colorado, that explicitly allow all minors to consent to contraceptive services. And 25 states explicitly permit minors to consent under one or more circumstances, such as a health risk related to that teen’s pregnancy or if the teen is married or already a parent. Four states have no explicit policy.

Colorado’s initiative provides no-cost or low-cost IUDs and other implants

at more than 68 family-planning clinics.

Much of the cost of the program over the last six years, $23.6 million, was donated by a Buffett family foundation that has supported clinics around the country.

The funding, which will continue through June, expanded clinics’ resources beyond what was available from state and federal sources, said Greta Klingler, family planning supervisor for the Colorado Department of Public Health and Environment. The donation allowed clinics to offer contraception at little or no cost. And, where needed, it increased clinic staff, space and hours.

The state family-planning program receives about $1.6 million a year in state general funds and $3.5 million a year in federal money through Title X Family Planning. Enacted in 1970, Title X built the family-planning clinic system, Klingler said.

Still, less than 5 percent of teens nationally are using IUDs and implants, according to a report by Colorado Youth Matter. More than 70 percent of Colorado youth used a condom the last time they had sex, though some are doubling up on methods to protect against sexually transmitted infections.

In Colorado, 41 percent of high school students reported having had sexual intercourse at least once, the report states. Even so, it says, they are more likely than those born in the 1970s were to delay sexual initiation.

An important element in driving down teen birth rates, Klingler said, is the statewide sex education standard — teaching abstinence and safe sex. Since 2013, parents are required to opt out rather than opt in.

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